Deborah Marshall to Lead Health Economics Work on Research that Will Transform Treatment for Children with Arthritis

Deborah Marshall, ABJHI’s Research Advisory Committee co-chair, is part of a team that has been awarded a $10-million grant for genomics research that will for the first time allow doctors to tailor treatment of childhood arthritis to the precise needs of the individual child in the earliest stages of the disease.

“We have the opportunity with genomic medicine to make treatment highly effective in the very early stages of juvenile arthritis averting serious joint damage that can lead to permanent disability in children,” Dr. Marshall said. Almost 25,000 children in Canada have arthritis.

Genomics examines the molecular mechanisms and the interplay of genetic and environmental factors in disease. Understanding these factors in individual patients can enable treatment to be tailored precisely to their genetic makeup and environment.

The research team will use genomics to develop a low-cost biomarker blood test that will rapidly identify the best treatment for each individual child with arthritis. Dr. Marshall will lead the health economics work.

“Time is the enemy in childhood arthritis,” Dr. Marshall said. “If treatments based on trial and error fail, the disease’s progress during this lost time can cause irreversible joint damage and a lifetime of disability.”

Biologics are a powerful class of medicine that can dramatically reduce joint pain and the inflammation that leads to joint damage. Early short-term biologic treatment, even for as little as three months, can bring long-lasting disease control in the most severely affected children, and possibly even cure the disease. However, biologics cost as much as $400,000 a year. Children may qualify for them only after traditional treatments have failed, by which time permanent damage may have occurred.

The biomarker blood test will quickly identify who will benefit from biologics, which biologic will work best for an individual child, and when the biologic can be safely stopped. “This would eliminate the hit-and-miss approach with conventional drugs that is used during the disease’s early stages. It also has the potential to save money by identifying – and thereby eliminating from treatment – the biologics that will have only limited positive effect,” Dr. Marshall said.

The research is being funded by Genome Canada in collaboration with the Canadian Institutes of Health Research, and co-funding partners. It is part of an investment of $162 million over four years in 15 new genomics and precision health projects.

The Research Team

Dr. Marshall is a member of the McCaig Institute for Bone and Joint Health and a professor in the University of Calgary’s Department of Community Health Sciences and the Arthur J.E. Child Chair in Rheumatology Outcomes Research. The research team is led by Dr. Susa Benseler, member of the McCaig Institute, professor, Cumming School of Medicine, University of Calgary, and staff rheumatologist at The Hospital for Sick Children (SickKids), Toronto, and Dr. Rae Yeung, senior scientist in cell biology research and Scientific Director, SickKids Biobank and the Hak-Ming and Deborah Chiu Chair in Translational Paediatric Research, SickKids. Other research team members are (from the Cumming School of Medicine) Drs. Marvin Fritzler, Marinka Twilt, Dianne Mosher, Gillian Currie, (from SickKids) Drs. Joseph Cafazzo, Jennifer Stinson, Stephen Scherer, Anna Goldenberg, Cynthia Guidos, Quaid Morris and Michael Brudno, (from Utrecht University, the Netherlands) Drs. Nico Wulffraat, Joost Swart and Sebastiaan Vastert, and (from University of Twente, the Netherlands) Dr. Maarten IJzerman.